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Myasthenia gravis is a chronic, complex, autoimmune disorder in which antibodies destroy neuromuscular connections. This causes problems with communication between nerves and muscle, resulting in weakness of the skeletal muscles. Myasthenia gravis affects the voluntary muscles of the body, especially the eyes, mouth, throat, and limbs.
Women affected by myasthenia gravis generally see onset of the condition by age 20 to 30. In men, it usually starts after the age of 50. However, this condition can occur at any age. Males are more often affected than females.
Myasthenia gravis is neither inherited, nor contagious. The disorder generally develops spontaneously later in life as a result of antibodies made in a person's body that attack normal receptors on muscle. This blocks the chemical released by the nerve endings (acetylcholine) from stimulating muscle contraction.
A temporary form of myasthenia gravis may develop in the fetus when a woman with myasthenia gravis passes the antibodies to the fetus. Generally, neonatal forms of myasthenia gravis resolve in 2 to 3 months.
The following are the most common symptoms of myasthenia gravis. However, each person may experience symptoms differently. Symptoms may include:
The symptoms of myasthenia gravis may resemble other conditions. Always consult your doctor for a diagnosis.
Flare-ups and remissions (easing of symptoms) may occur periodically during the course of myasthenia gravis. Remissions, however, are only rarely permanent or complete.
The diagnosis of myasthenia gravis is made after the sudden or gradual onset of specific symptoms and after diagnostic testing. During the physical exam, the doctor will ask about your medical history and symptoms.
One common way to diagnose myasthenia gravis is to test how a person responds to certain medications. Muscle weakness often dramatically improves for a brief time when a person with myasthenia gravis is given an anticholinesterase medication. If a person responds to the medication, it confirms myasthenia gravis.
Other diagnostic tests that may be done to help confirm the diagnosis of myasthenia gravis include:
Specific treatment for myasthenia gravis will be determined by your health care provider based on:
There is no cure for myasthenia gravis, but the symptoms can generally be controlled. Myasthenia gravis is a lifelong medical condition and the key to medically managing it is early detection.
The goal of treatment is to increase muscle function and prevent swallowing and breathing problems. Most people with this condition can improve their muscle strength and lead normal or near normal lives. In more severe cases, respiratory or nutritional support may be needed.
Treatment may include:
Myasthenia crisis is a condition of extreme muscle weakness, particularly of the diaphragm and chest muscles that support breathing. Breathing may become shallow or ineffective. The airway may become obstructed because of weakened throat muscles and secretion accumulation. Myasthenia crisis may be caused by a lack of medication or by other factors, such as a respiratory infection, emotional stress, surgery, or some other type of stressor. In severe crisis, a person may have to be placed on a ventilator to assist breathing until muscle strength returns with treatment.
Precautions, which may help to prevent or minimize the occurrence of myasthenia crisis, include, but are not limited to, the following:
Notify any health care provider of your condition when any medications are being prescribed as certain medications may interfere either with the disease or the action of the medications you take for myasthenia gravis.
The goal of treatment is to increase general muscle function and prevent swallowing and breathing problems. Most people with myasthenia gravis can improve their muscle strength and lead normal or near normal lives. In more severe cases, respiratory or nutritional support may be required..
Call your doctor if any of the following occur:
Tips to help you get the most from a visit to your health care provider:
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.